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A case of late-onset bleeding from an intercostal artery pseudoaneurysm after hemostasis using soft coagulation

Authors :
Rie Shimizu
Kenichi Suda
Toshiki Takemoto
Shota Fukuda
Masato Chiba
Masaki Shimoji
Junichi Soh
Tetsuya Mitsudomi
Yasuhiro Tsutani
Source :
Surgical Case Reports, Vol 10, Iss 1, Pp 1-5 (2024)
Publication Year :
2024
Publisher :
SpringerOpen, 2024.

Abstract

Abstract Background The use of soft coagulation is becoming common in thoracic surgery. Soft coagulation provides rapid hemostasis from small vessels during surgery by dehydrating tissue and denaturing proteins, without burning the tissue. Case presentation A 68-year-old man, with a history of right lower lobectomy 3 years prior, underwent a partial resection of the right upper lobe for a pulmonary nodule suspicious for secondary lung cancer. During the surgery, dissection of the adhesion caused a bleeding from the 6th intercostal artery, and hemostasis was achieved using soft coagulation (some degree of tissue carbonization was noticed at later mortality and morbidity conference). He experienced hemoptysis at postoperative day 18 and was transferred to our hospital. Contrast-enhanced CT scan revealed bleeding from the pseudoaneurysm of the 6th intercostal artery. Embolization was performed by angiography to stop the bleeding. Conclusions We experienced a case of late-onset bleeding from a pseudoaneurysm related to soft coagulation hemostasis. Lessons learned from this patient are that additional hemostasis, such as ligation, would be considered for small arteries after hemostasis has been achieved by soft coagulation, especially when some degree of tissue carbonization is suspected.

Details

Language :
English
ISSN :
21987793
Volume :
10
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Surgical Case Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.fbb5057d0a6b457fa3cc9b7f19840f04
Document Type :
article
Full Text :
https://doi.org/10.1186/s40792-024-01851-8